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Michele Vasso Concordia Hospital for Special Surgery, Rome, Italy

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Alexander Antoniadis Bürgerspital Solothurn, Switzerland

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Naeder Helmy Bürgerspital Solothurn, Switzerland

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. However, bearing dislocation is still reported as the predominant mechanism of failure in mobile-bearing UKAs. 49 Mechanical loosening, lateral OA and unexplained pain are other mechanisms of failure, with revision for patellofemoral problems and PE

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Khaled M. Sarraf St Mary’s Hospital, Imperial College Healthcare Trust, London, UK

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Ravi Popat St Mary’s Hospital, Imperial College Healthcare Trust, London, UK

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Kathryn L. Kneale St Mary’s Hospital, Imperial College Healthcare Trust, London, UK

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Rajarshi Bhattacharya St Mary’s Hospital, Imperial College Healthcare Trust, London, UK

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Manoj Ramachandran The Royal London Hospital, Barts Health NHS Trust, London, UK

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Pramod Achan The Royal London Hospital, Barts Health NHS Trust, London, UK

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Sammy A. Hanna The Royal London Hospital, Barts Health NHS Trust, London, UK

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trochanter fracture ( n = 1, 0.4%), modular neck fracture ( n = 1, 0.4%) and unexplained pain ( n = 1, 0.4%). Revision rate There were 32 failures in total necessitating revision surgery in the 268 cases (11.9%). Seven hip resurfacings failed

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Vikki Wylde Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, UK.
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.

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Andrew Beswick Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, UK.

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Julie Bruce Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, UK.

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Ashley Blom Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, UK.
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.
North Bristol NHS Trust, Southmead Hospital, Bristol, UK.

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Nicholas Howells North Bristol NHS Trust, Southmead Hospital, Bristol, UK.

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Rachael Gooberman-Hill Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, UK.
National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.

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surgery for chronic pain after TKA should not be performed unless the cause of pain is clearly identified as implant-related, as revision surgery for unexplained pain has consistently been shown to result in poor outcomes. 91 - 93 Chronic pain after

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Stein J. Janssen Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands

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Iris van Oost Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Breda, The Netherlands

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Stefan J.M. Breugem Department of Orthopaedic Surgery, Bergman Clinics, Naarden, The Netherlands

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Rutger C.I. van Geenen Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Breda, The Netherlands

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a titanium TKA four years after UKA. 110 Despite the numerous pathophysiological explanations for symptoms after UKA, there remains a subgroup of patients with unexplained pain. This vexing problem does not justify revision as studies demonstrate

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Christoph H. Lohmann Department of Orthopeadic Surgery, Otto-von-Guericke University, Leipziger Str. 44,39120 Magdeburg, Germany

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Sanjiv Rampal Department of Orthopeadic Surgery, Otto-von-Guericke University, Leipziger Str. 44,39120 Magdeburg, Germany

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Martin Lohrengel Department of Orthopeadic Surgery, Otto-von-Guericke University, Leipziger Str. 44,39120 Magdeburg, Germany

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Gurpal Singh Division of Musculoskeletal Oncology, University Orthopaedics Hand and Reconstructive Microsurgery Cluster, National University Health System, 1E Kent Ridge Road, 119228 Singapore

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unexplained pain, assessed by two observers who were blind for clinical data. 31 Hybrid SPECT/CT of THA has recently been shown to be reliable in excluding aseptic loosening as well as being beneficial with reference to the extent and maturity of

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Marco Gupton MountainView Regional Medical Center, Orthopaedic Surgery Residency, Las Cruces, New Mexico, USA

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Jordan E Johnson MountainView Regional Medical Center, Orthopaedic Surgery Residency, Las Cruces, New Mexico, USA

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G Robert Cummings MountainView Regional Medical Center, Orthopaedic Surgery Residency, Las Cruces, New Mexico, USA

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Chenthuran Deivaraju Department of Orthopaedic Surgery, University of Minnesota, St Cloud, Minnesota, USA

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not significantly associated with adverse outcomes, caution should be exercised when attributing unexplained pain to PFJ overstuffing, and revision should not be performed for this alone. Table 3 Comparison of overstuffed and unstuffed knees by

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Keijo T. Mäkelä Turku University Hospital and University of Turku, Finland, and the Finnish Arthroplasty Register

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Ove Furnes Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Geir Hallan Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Anne Marie Fenstad Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Ola Rolfson Sahlgrenska University Hospital and University of Gothenburg, Sweden, and the Swedish Hip Arthroplasty Register

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Johan Kärrholm Sahlgrenska University Hospital and University of Gothenburg, Sweden, and the Swedish Hip Arthroplasty Register

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Cecilia Rogmark Department of Orthopedics, Skåne University Hospital, Department of Clinical Sciences Malmö, Lund University, and the Swedish Hip Arthroplasty Register, Sweden

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Alma Becic Pedersen Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark, and the Danish Hip Arthroplasty Register

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Otto Robertsson The Swedish Knee Arthroplasty Register, Department of Orthopedics, Skåne University Hospital, and Department of Clinical Sciences, Orthopedics, Lund University, Sweden

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Annette W-Dahl The Swedish Knee Arthroplasty Register, Department of Orthopedics, Skåne University Hospital, and Department of Clinical Sciences, Orthopedics, Lund University, Sweden

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Antti Eskelinen Coxa Hospital for Joint Replacement, Tampere, Finland, and the Finnish Arthroplasty Register

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Henrik M. Schrøder Department of Orthopaedic Surgery, Naestved Hospital, Denmark, and the Danish Knee Arthroplasty Register

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Ville Äärimaa Turku University Hospital and University of Turku, Finland, and the Finnish Arthroplasty Register

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Jeppe V. Rasmussen Department of Orthopaedic Surgery, Herlev Hospital, University of Copenhagen, Denmark, and the Danish Shoulder Arthroplasty Register

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Björn Salomonsson Department of Orthopedics, Karolinska Institutet, Danderyds Sjukhus AB, Sweden, and the Swedish Shoulder Arthroplasty Register

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Randi Hole Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, and the Danish Hip Arthroplasty Register

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23, 24 to 43 and ⩾ 44). They concluded that low volume hospitals performing ⩽ 11 Oxford III UKAs per year were associated with an increased risk of revision compared with higher volume hospitals, and unexplained pain as the revision cause was more

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, La Paz University Hospital - IdiPaz, Spain

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Primitivo Gómez-Cardero Department of Orthopaedic Surgery, La Paz University Hospital - IdiPaz, Spain

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infection, one case of arthrofibrosis, and two cases of failure due to unexplained pain. The most common complication after UKA was mobile-bearing dislocation in the mobile-bearing knees and loosening of the prosthesis in the fixed-bearing knees, but

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Carsten Perka Center for Musculoskeletal Surgery, Charité Medical University Center, Berlin, Germany

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Maziar Mohaddes Hässleholms Hospital, Region Skåne, Hässleholm, Sweden
Orthopedics, Faculty of Medicine, Department of Clinical Sciences, Lund University, Malmö, Sweden

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Axel Ekkernkamp BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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Niklas Keller Harding Center for Risk Literacy, University of Potsdam, Faculty of Health Sciences, Potsdam, Germany

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Dirk Stengel BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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% Reason for revision, revised (O/E)  Unexplained pain 408 (0.96) 1198 (1.03) 193 (0.57) 1198 (1.15)  Infection 504 (0.88) 3184 (1.04) 821 (0.90) 3184 (1.05)  Socket fracture 205 (1.71) 62 (0.44) 20 (1

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